In the Bronx, Cockroaches Are Not Just a Pest Problem. They’re an Asthma Problem

Homes with cockroaches in New York City – 2017 Source: New York City Housing and Vacancy Survey. Chart: NYC Health Department – Environment and Health Data Portal

Public school teacher Shannon Threatt and her asthmatic husband say they are prisoners to the cockroaches infesting their South Bronx home. The insects overrun the kitchen and persist despite the poison traps replaced every month.

“We’re struggling, we’re trying to stay clean,” Threatt said, her face flushed with embarrassment. For six months, she’s fought the roaches, calling the building owner nearly every month. The landlord has hired an exterminator, but “he doesn’t seem to do much,” she said.

City health data show that almost half of South Bronx households report they have cockroaches, compared to less than a quarter of homes citywide. The Bronx is also the only borough where these numbers are rising. While some consider roaches a nuisance, these insects release proteins in their saliva and droppings that can inflame airways and trigger asthma attacks.

The Bronx has more than double the rate of pediatric asthma-related emergency visits compared to all other boroughs combined, according to the 2021 Epi Data Brief. While air pollution and secondhand smoke may contribute, cockroach infestations are a known factor.

Cockroaches are not the only pest problem. Nearly a third of households in the Bronx report mice or rats, both of which can trigger asthma, compared to less than a quarter of homes citywide. Mold is another common indoor asthma trigger, and more Bronx residents report mold in their homes than in any other borough.

This fall, pest control company Orkin released its 2024 report of the most rat-infested cities in America. New York City ranked number three, with New York state representing the most cities on the list. In September, Mayor Eric Adams hosted the city’s first National Urban Rat Summit to discuss strategies for tackling this public health issue. Some hands-on programs are already in place to help reduce exposure to indoor pests.

The city health department’s Healthy Homes Program (HHP) accepts referrals from physicians who have asthmatic patients struggling with pests or mold. Once referred, HHP schedules a home inspection and hires an exterminator, followed by another inspection to ensure the problem is resolved.

“What’s beautiful about this program is that once you’ve made a referral and they’ve done a home visit, the landlord has 21 days to make a change,” said Stephanie Lovinsky-Desir, a pediatric pulmonologist and asthma specialist at Columbia University’s Irving Medical Center. “It adds a little extra power in the hands of some of our patients and their families who often feel powerless about their housing conditions.”

The HHP falls within Local Law 55, which allows residents themselves to file complaints about indoor allergen hazards to landlords, who are responsible for remediation. Lori Hoepner, an assistant professor of environmental and occupational health sciences at the SUNY Downstate School of Public Health, said that even though the onus is on the landowner to keep the building in good repair, the tenant may still choose not to complain.

“There may be fear in retaliation for reporting,” said Hoepner, citing the concern that the landowner will raise rent for any improvements made to a privately owned property.

Though physicians can refer asthmatic patients to home inspection programs, many neighborhoods in the Bronx lack primary care facilities. Only about a third of diagnosed asthmatic children in Bronx public schools have a physician-signed Medication Administration Form, which permits school nurses to give students medication as needed, compared to nearly half citywide.

These numbers suggest that even when children in the Bronx are diagnosed with asthma, they may not have easy access to a pediatrician. As a result, programs like Healthy Homes may benefit those with better healthcare access, leaving many Bronx families still desperate for care.

“The work I can do with an individual patient – I can prescribe them medications and try to get them help – is only a teeny tiny drop in the bucket,” said Lovinsky-Desir. “There are so many families that are experiencing this, and the real way to fix it is at the policy level.”